CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2013; 04(01): 013-015
DOI: 10.1055/s-0039-1700263
Case Report
Society of Gastrointestinal Endoscopy of India

Esophagojejunal anastomotic leak managed with self expandable metallic stent

Arvind Madurandagam Annapillai
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Biggs Saravanan Ramachandran
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Senthilkumar Ponniah
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Hemamala V.
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Kesavan B.
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Premkumar Karunakaran
1   Department of Medical and Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Prabhakaran Raju
2   Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Manoharan G.
2   Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Chandramohan Servarayan Murugesan
2   Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
,
Mohammed Ali Muhammed
2   Department of Surgical Gastroenterology, Rajiv Gandhi Government General Hospital, Madras Medical College (MMC), Chennai, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

ABSTRACT

Esophagealjejunal anastomotic leak after gastrectomy is a serious surgical emergency with high mortality. This report describes a 57-year-old male with esophagojejunal anastomotic leak following total gastrectomy for gastric cancer and was managed successfully with self-expandable metallic stent. To our knowledge this is the first such report from India. This case report highlights the need of interdisciplinary coordination in managing this difficult clinical situation. Endotherapy with self-expandable metallic stent (SEM) provided twin benefits of improving respiratory embarrassment and the joy of eating. Therapy of such difficult cases must be individualized; however, and SEM stent usage is a viable option (J Dig Endcsc 2013;4(1):13–15)

 
  • References

  • 1 Classification of adenocarcinoma of the esophagogastric junction. Br J Surg 1998;85:1457-9.
  • 2 Alanezi K, Urschel JD. Mortality secondary to esophageal anastomotic leak. Ann Thorac Cardiovasc Surg 2004;10:71-5.
  • 3 Kakavoulis TN, Avgoustou CC, Koniaris HG, Penlidis PC. Subcutaneous esophagojejunal reconstruction in the management of esophagogastric anastomotic leak: a staged procedure. Dis Esophagus 2005;18:345-8.
  • 4 Lang H, Piso P, Stukenborg C, Raab R, Jähne J. Management and results of proximal anastomotic leaks in a series of 1114 total gastrectomies for gastric carcinoma. Eur J Surg Oncol 2000;26:168-71.
  • 5 Qadeer MA, Dumot JA, Vargo JJ, Lopez AR, Rice TW. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. GastrointestEndosc 2007;66:605-11.
  • 6 Truong S, Bohm G, Klinge U, Stumpf M, Schumpelick V, et al. Results after endoscopic treatment of postoperative upper gastrointestinal fistulas and leaks using combined Vicryl plug and fibrin glue. Surg Endosc 2004;18:1105-8.
  • 7 Yonggang LV, Shifang Yuan, Jun Yun, Qing Yao, Jianghao Chen, Jun Yi, Rui Ling, Ling Wang. Management of intrathoracic leakage after radical total gastrectomy. J Thorac Dis 2010; 2: 180-84.
  • 8 Profili S, Feo CF, Cossu ML, Scanu AM, Scognamillo F, Meloni F, et al. Effective management of intrathoracic anastomotic leak with covered self-expandable metal stents. Report on three cases. Emerg Radiol 2008;15:57-60.
  • 9 Kauer WK, Stein HJ, Dittler HJ, Siewert JR. Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy. Surg Endosc 2008; 22:50-3.
  • 10 Fernández A, Vila JJ, Vázquez S, González-Portela C, de la Iglesia M, Lozano M, Toscano E. Self-expanding plastic stents for the treatment of post-operative esophago-jejuno anastomosis leak. A case series study. Rev Esp Enferm Dig 2010;102:704-10.